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General NPI Number Information
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NPI Number | 1124988092
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Entity Type | Organization
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Legal Business Name | WEST KNOXVILLE DENTAL ASSOCIATES
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 310 SIMMONS RD STE I
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City | KNOXVILLE
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State | TN
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Zip | 37922-1943
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Country | US
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Telephone | 360-513-5328
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Fax |
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Provider Business Mailing Address
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Address Line | 310 SIMMONS RD STE I
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City | KNOXVILLE
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State | TN
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Zip | 37922-1943
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Country | US
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Telephone | 360-513-5328
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEARSTIN STALLINGS
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Credential |
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Telephone | 770-307-8726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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